National survey of telehealth neuropsychology practices: current attitudes, practices, and relevance of tele-neuropsychology three years after the onset of Covid-19.

Objective: Examination of current tele-neuropsychology (teleNP) practices and attitudes within the clinical neuropsychology community, conducted September - November 2022. Method: Clinical neuropsychologists in U.S. and U.S. territories were invited to participate in an online survey of teleNP practices. The final sample consisted of 326 neuropsychologists. Results: Forty-six percent of the sample indicated they currently practice teleNP. Fourteen percent of the sample not currently practicing teleNP were considering practicing teleNP. The remainder was not practicing teleNP and had no plans to (41%). Most respondents agreed that teleNP where the patient is located in clinic is generally feasible and acceptable (71%); to a lesser extent, teleNP to home was viewed as feasible and acceptable (45% agreed, while 16% rated feasibility and acceptability as neutral). Only 11% agreed that teleNP is a feasible and acceptable part of forensic neuropsychology practice. Most respondents (74%) currently engaged in teleNP either agreed or strongly agreed that teleNP enabled them to provide similar quality of care as face-to-face neuropsychology. Current practice of teleNP was positively correlated with career phase, with greater adoption among early career neuropsychologists. Current teleNP providers anticipated teleNP to permanently comprise 31-40% of their overall practice on average. Conclusions: There is variability in teleNP acceptance by setting and career phase. While hesitancy around teleNP was expressed by some, results show that the adoption of teleNP has increased over time and remains a permanent feature of practice for a substantial number of respondents three years following onset of the Covid-19 pandemic.